Objective To observe whether peripheral blood mononuclear cells (PBMCs) from patients with active systemic lupus erythematosus (SLE) can induce the adhesion of T lymphocytes to endothelial cells. Methods Sera and PBMCs were obtained from patients with active SLE and normal human controls. PBMCs were cultivated and culture supematants were harvested. Human umbilical vein endothelial cells (HUVECs) were cultured in vitro with or without the presence of the sera or culture super-natants of PBMCs. Some cells were pretreated with the antibody to IL-17 before the treatment with the sera or supematants. After another 48-hour culture, RT-PCR and real-time PCR were used to detect the mRNA expressions of adhesion molecules, including intercellular adhesion moleeule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-cadherin in HUVECs, wound healing assay to estimate the motility of HUVECs. Additionally, T lymphocytes were added to HUVECs 48 hours after stimulation with the sera or supematants, the adhering of T lymphocytes to HUVECs was observed by microscopy. Results After stimulation with supematants of PBMCs from patients with active SLE, the mRNA expressions of ICAM-1, VCAM-1 and E-cadherin were significantly increased in HUVEC, while the increase could be inhibited by the antibody to IL-17. The elevation of adhesion molecule expression subsequently promoted the motility of HUVEC, mediated the adhesion of T lymphocytes to HUVEC, and the antibody to IL-17 could suppress the adhesion of T lymphocytes and motility of HUVEC. Conclusion The culture supematants of PBMCs from patients with active SLE can induce the expression of vascular cell adherin molecules and promote the adherin of T lymphocytes, which may in turn mediate the development of lupus vasculitis.

Objective To investigate influence of laser positioning system to position repeatability of patients treated with radiotherapy for pelvic tumors.Methods Forty patients with pelvic tumors were divided into two groups,using laser positioning system positioning (20 cases) and conventional positioning (20 cases),respectively,CBCT was used to verify and analyze the setup errors of two groups.Results The setup errors on X,Y and Z axes in laser positioning system positioning group were (2.63±1.07) mm,(2.38±1.28) mm and (2.46±1.21) mm,they were (3.04±1.22) mm,(2.55±1.35) mm and (3.09±1.37) mm in conventional positioning group.It has significance reduce on X and Z axes (P =0.040,0.003,respectively) by using laser positioning system,and has no significance on Y axis (P =0.432).Conclusion It can improve patient positioning repeatability effectively by using laser positioning system for patient positioning.

Objective To evaluate the application of improved belly board in postoperative patients of rectal cancer radiotherapy and explore the influence of its set-up repeatability.Methods CBCT was used to measure the intra fractional and inter fractional setup errors using normal or improved belly board respectively.The data was analyzed with statistic method.Results There was no significance of intra fractional setup errors on x-axis (P ＞ 0.05).There was significance on y and z-axis (P ＜ 0.05).There was no significance of interfrational setup errors on x-axis (P ＞ 0.05) and there was significance on y and z-axis (P ＜ 0.05) using normal belly board.There was no significance of intrafractional setup errors on x,y and z-axis (P ＞ 0.05).There was also no significance of interfractional setup errors on x,y and z-axis (P ＞ 0.05) with using improved belly board.Conclusion The method of improved belly board has more advantage than nomal belly board in controlling set-up repeatability,and it is conductive to improve accuracy of patients treatment.

Objective To evaluate the clinical application of implantation of totally implantable venous access port (TIVAP) via the internal jugular vein (IJV) guided by ultrasonography in infants.Methods The clinical data of 446 sick infants,who received TIVAP at the Affiliated Shanghai Children's Medical Center,School of Medicine,Shanghai Jiaotong University,China (single center) during the period from January 2009 to July 2016,were retrospectively analyzed.The time spent on surgery,the success rate of first puncturing of IJV and the incidence of puncture-related complications were recorded,and the results were compared between traditional IJV blind puncture group and ultrasound-guided IJV puncture group.Results Of the 446 sick infants,traditional IJV blind puncture was employed in 265 and ultrasound-guided IJV puncture was adopted in 181.In traditional IJV blind puncture group,the mean time spent on surgery was 7.6 min,the success rate of first puncturing of IJV was 75.85％ (201/265),and the incidence of puncturerelated complications was 5.66％ (15/265).In ultrasound-guided IJV puncture group,the mean time spent on surgery was 4.2 min,the success rate of first puncturing of IJV was 97.24％(176/181),and the incidence of puncture-related complications was 1.70％ (3/181).Conclusion For the performance of TIVAP implantation in sick infants,the use of ultrasound-guided IJV puncture technique can shorten the operation time,improve the success rate of first puncturing,and reduce the incidence of puncture-related complications.Therefore,ultrasound-guided IJV puncture is a safe,effective,simple and feasible technique.This technique is worthy of clinical promotion.

Objective To establish animal model of prolactinoma with Fischer 344 (F344) rats.MethodsFemale F344 rats were injected with estradiol benzoate-treated and 0.9% sodium chloride respectively. After 50 days of treatment, MRI scan was performed and animal's living status was observed, and pituitary weight, serum prolactin level, pathological and PRL immunohistochemistry changes were also detected.ResultsAll estradiol benzoate-treated rats formed the prolactinoma after treatment for 50 days and the growth of body weight was retarded obviously. Pituitary weight and serum PRL increased significantly in estradiol benzoate-treated animals compared with those treated with 0.9% sodium chloride. Pituitary adenomas were found in MRI scan and HE stain was positive. The forming rate of tumor was 100%.ConclusionThe animal model of pituitary adenoma established with F344 rat has more characters such as having a short tumor forming period, easy and stable, and coincided with features of prolactinoma.

Cerebrospinal Fluid Rhinorrhea ; diagnosis ; etiology ; Chondrosarcoma ; surgery ; Endoscopy ; Enterococcus ; pathogenicity ; Humans ; Male ; Meningitis ; diagnosis ; microbiology ; Middle Aged ; Skull Base ; pathology ; surgery

objective To investigate the tissue localization of CD4+T cells producing IL-17,namely Th17 cells.in patients with systemic lupus erythematosus (SLE),as well as its relationship with the activity of lupus.Methods By using H&E staining.double-label immunofluorescence.immunohistochemistry and confocal microscopy.the localization of Th17 cells was carried out in peripheral blood mononuclear cells (PBMCs).affected tissue of skin and lung obtained from 4 patients with active SLE and 2 normal human controls.Flow cytometry.reverse transcription PCR.ELISA were used to detect the proportion of Th17 cells in PBMCs,the mRNA expression of interleukin-17(IL-17)A and IL-17 F,and serum level of interleukin 17,respectively,in 50 consecutive adult patients with SLE and 15 normal human controls.Results Th17 cells were detected in PBMCs of patients with active SLE.and the fuorescence intensity of IL-17 was significantly higher in patients with active SLE than in normal human controls(127.6±20.5 vs 40.6±11.1,P＜0.001).Infiltrates of Th17 cells were noted in both skin and lung tissues of patients with active SLE.but not in those of normal human controls.The proportion of Th17 cells in PBMCs was increased in patients with active SLE.and the proportion positively correlated with SLE disease activity index(SLEDAI) (r=0.725,P＜0.01).Further more.a significant increase was observed in the mRNA expression of IL-17 A and IL-17 F and serum level of IL-17 in patients with active SLE compared with normal human controls.The amount of Th17 cells was positively correlated with the development of vasculitis.and it experienced a decrease with the remission of SLE.Conclusions A proliferation of Th17 cells is noted in patients with active SLE.which seems to closely correlated with the activity of SLE and may take part in the development of vasculitis in SLE.

Objective To evaluate the effect of spleno-left adrenal vein shunt for the treatment of portal hypertensive upper GI bleeding caused by portal vein cavernous transformation in children.Methods Spleno-left adrenal vein shunt was performed in 8 children with portal hypertension due to cavernous transformation.The clinical data was reviewed.Results Portal vein pressure decreased significantly from (30±11)mm Hg to(22±7) mm Hg after shunt.There was no mortality perioperatively and during the follow-up.There were no recurrent hemorrhage nor hepatic encephalopathy occurring in the follow-up and all the children have normal intelligence and normal liver function though blood ammonia level increased significantly from(18±7)μmol/L to (60±17)μmol/L in 4 cases.In 7 cases in which preoperative whole blood cell count significantly decreased,the postoperative WBC,RBC,Hb and PLT was (7.64 ±4.46)×10~9/L,(4.54±0.97)×10~(12)/L,(133±5) g/L and (355.40±107.36)×10~9/L respectively (all P ＜0.05).In one case suffering from preoperative low PLT count the postop PLT reached 333×10~9/L,which was significantly higher than that preoperatively.Esophageal varices ameliorated in 6 cases.No stenosis of anastomotic stoma and thrombosis developed.Conclusion Spleno-left adrenal vein shunt is an effective procedure to treat portal vein cavernous transformation induced portal hypertension in children.

Objective To explore the liver toxicities of the VDLD scheme in children with malignant tumor.Methods In a prospective trial,the levels of serum total protein,albumin, globulin,rate of albumin/globuin alanine aminotransferase,aspartate transaminase,gamma glutamyltranspeptidase,total bile acid and alkaline phosphatase were tested in children with malignant tumour before and after VDLD scheme,and compared with each other.Results The concentration of the serum total bile acid was significantly increased after VDLD scheme than before(P

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